Orbitofrontal sulcogyral morphology in patients with cocaine use disorder

Variability and concordance of sulcal patterns in the orbitofrontal cortex: A twin study

Sulcogyral patterns have been identified in the orbitofrontal cortex (OFC) based on the continuity of the medial and lateral orbital sulci. Pattern types are named according to their frequency in the population, with Type I present in ∼60%, Type II in ∼25%, Type III in ∼10%, and Type IV in ∼5%. Previous work has demonstrated that psychiatric conditions with high estimated heritability (e.g. schizophrenia, bipolar disorder) are associated with reduced frequency of Type I patterns, but the general heritability of the OFC sulcogyral patterns is unknown. We examined concordance of OFC patterns in 304 monozygotic (MZ) twins relative to 172 dizygotic (DZ) twins using structural magnetic resonance imaging data. We find that the frequency of pattern types within MZ and DZ twins are similar and bilateral concordance rates across all pattern types in DZ twins were 14% and 21% for MZ twins. Results from follow-up analyses confirm that continuity in the rostral-caudal direction is an important source of variability within the OFC, and subtype analyses indicate that variability is present in other sulci that are not represented by overall OFC pattern type. Overall, these results suggest that OFC sulcogyral patterns may reflect important variance that is not genetic in origin.

Genetics and prescription opioid use (GaPO): study design for consenting a cohort from an existing biobank to identify clinical and genetic factors influencing prescription opioid use and abuse

BACKGROUND

Prescription opioids (POs) are commonly used to treat moderate to severe chronic pain in the health system setting. Although they improve quality of life for many patients, more work is needed to identify both the clinical and genetic factors that put certain individuals at high risk for developing opioid use disorder (OUD) following use of POs for pain relief. With a greater understanding of important risk factors, physicians will be better able to identify patients at highest risk for developing OUD for whom non-opioid alternative therapies and treatments should be considered.

METHODS

We are conducting a prospective observational study that aims to identify the clinical and genetic factors most stongly associated with OUD. The study design leverages an existing biobank that includes whole exome sequencing and array genotyping. The biobank is maintained within an integrated health system, allowing for the large-scale capture and integration of genetic and non-genetic data. Participants are enrolled into the health system biobank via informed consent and then into a second study that focuses on opioid medication use. Data capture includes validated self-report surveys measuring addiction severity, depression, anxiety, and nicotine use, as well as additional clinical, prescription, and brain imaging data extracted from electronic health records.

DISCUSSION

We will harness this multimodal data capture to establish meaningful patient phenotypes in order to understand the genetic and non-genetic contributions to OUD.

Towards Deciphering the Fetal Foundation of Normal Cognition and Cognitive Symptoms From Sulcation of the Cortex

Growing evidence supports that prenatal processes play an important role for cognitive ability in normal and clinical conditions. In this context, several neuroimaging studies searched for features in postnatal life that could serve as a proxy for earlier developmental events. A very interesting candidate is the sulcal, or sulco-gyral, patterns, macroscopic features of the cortex anatomy related to the fold topology-e.g., continuous vs. interrupted/broken fold, present vs. absent fold-or their spatial organization. Indeed, as opposed to quantitative features of the cortical sheet (e.g., thickness, surface area or curvature) taking decades to reach the levels measured in adult, the qualitative sulcal patterns are mainly determined before birth and stable across the lifespan. The sulcal patterns therefore offer a window on the fetal constraints on specific brain areas on cognitive abilities and clinical symptoms that manifest later in life. After a global review of the cerebral cortex sulcation, its mechanisms, its ontogenesis along with methodological issues on how to measure the sulcal patterns, we present a selection of studies illustrating that analysis of the sulcal patterns can provide information on prenatal dispositions to cognition (with a focus on cognitive control and academic abilities) and cognitive symptoms (with a focus on schizophrenia and bipolar disorders). Finally, perspectives of sulcal studies are discussed.